Kim M, Vengatesan K, Aploks K, Thompson K, Dong X, Seshadri R. National Cancer Database analysis of gallbladder cancer: Evaluating survival benefit of chemotherapy in early-stage gallbladder cancer. World J Gastrointest Surg 2025; 17(5): 103653 [DOI: 10.4240/wjgs.v17.i5.103653]
Corresponding Author of This Article
Ramanathan Seshadri, MD, Doctor, Division of Surgical Oncology/Hepato-Pancreato-Biliary Surgery, Danbury Hospital, 95 Locus Avenue, Danbury, CT 06810, United States. ramanathan.seshadri@nuvancehealth.org
Research Domain of This Article
Surgery
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. May 27, 2025; 17(5): 103653 Published online May 27, 2025. doi: 10.4240/wjgs.v17.i5.103653
National Cancer Database analysis of gallbladder cancer: Evaluating survival benefit of chemotherapy in early-stage gallbladder cancer
Minha Kim, Keerthivasan Vengatesan, Krist Aploks, Kyle Thompson, Xiang Dong, Ramanathan Seshadri
Minha Kim, Keerthivasan Vengatesan, Krist Aploks, Department of General Surgery, Danbury Hospital, Danbury, CT 06810, United States
Kyle Thompson, Department of Clinical Research, Danbury Hospital, Danbury, CT 06810, United States
Xiang Dong, Ramanathan Seshadri, Division of Surgical Oncology/Hepato-Pancreato-Biliary Surgery, Danbury Hospital, Danbury, CT 06810, United States
Author contributions: Kim M, Aploks K, Vengatesan K, Dong X, and Seshadri R contributed to the conceptualization of the project; Kim M, Aploks K, Thompson K, Dong X, and Seshadri R contributed to the methodology and validation of the data; Thompson K conducted the formal statistical analyses; Kim M, Vengatesan K, and Aploks K prepared the original manuscript; Kim M, Vengatesan K, Aploks K, Thompson K, Dong X, and Seshadri R contributed to the final draft revision and edition; Dong X, and Seshadri R supervised the project.
Institutional review board statement: Ethical review and approval was not required for this study since the data used was de-identified and obtained from a participant use file.
Informed consent statement: This study is a retrospective review that utilized only de-identified patient data from the National Cancer Database.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ramanathan Seshadri, MD, Doctor, Division of Surgical Oncology/Hepato-Pancreato-Biliary Surgery, Danbury Hospital, 95 Locus Avenue, Danbury, CT 06810, United States. ramanathan.seshadri@nuvancehealth.org
Received: November 28, 2024 Revised: March 1, 2025 Accepted: April 2, 2025 Published online: May 27, 2025 Processing time: 176 Days and 2.9 Hours
Abstract
BACKGROUND
For locally advanced gallbladder cancer, previous clinical studies have demonstrated that chemotherapy results in significant survival benefits when compared to surgery alone. However, data demonstrating a similar survival benefit with early-stage gallbladder cancer is limited. This study seeks to evaluate the impact chemotherapy has on survival in patients with early-stage gallbladder cancer using a large, multi-institution database.
AIM
To investigate the survival benefit of chemotherapy in patients with stage II gallbladder cancer.
METHODS
We performed a retrospective multivariable analysis of the National Cancer Database from 2010 to 2017 to evaluate the effect that chemotherapy has on the survival of patients with stage II gallbladder cancer. Our objective was to determine if there were any statistically significant survival differences between those who received surgery and chemotherapy vs those who only underwent surgery.
RESULTS
Of the 899 patients with stage II gallbladder cancer, 328 patients had undergone chemotherapy and surgery. The average overall survival for those who had surgery and chemotherapy vs only surgery was 52.6 months and 51.1 months, respectively. This difference was not statistically significant (P = 0.2). In the secondary analysis, the surgical group who had a liver resection had better overall survival (P < 0.0001).
CONCLUSION
Practitioners should carefully consider chemotherapy for early-stage gallbladder cancer, as risks may outweigh survival benefits, and surgeons should also consider liver resections as part of their surgical management.
Core Tip: In this retrospective study, we utilized the National Cancer Database to evaluate the effect that chemotherapy has on survival of patients with stage II gallbladder cancer. While the role of chemotherapy is being investigated for stage II gallbladder cancer, surgeons should exercise caution when recommending chemotherapy to patients with early-stage gallbladder cancer as the risks may outweigh the survival benefits. Our study showed that there was no statistically significant difference in survival between the those who underwent surgery and chemotherapy compared to those who only had surgery for stage II gallbladder cancer.
